From J. Stanley Gardiner (1898), "The Natives of Rotuma," Journal
of the Royal Anthropological Institute 27:491-496.

XXII. MEDICINE AND SURGERY.

The Rotuman of the present day is singularly ignorant of even the
most elementary medicine and surgery. As before pointed out (p.
468), the priests were the doctors; it was a mystery handed down
from father to son with the office. When Christianity began to be taught,
and white men settled on the island, the mystery was guarded still
more carefully, and most of the art has unfortunately now been lost.
At the present day medicines are dispensed by the Roman Catholic priests
and the Commissioner, but Fijians resident on the island are very generally
called in, if the patient does not recover instantaneously.

The great Rotuman cure for every pain or ache in the body is massage
of a very severe nature, either with cocoanut oil or the oil of the hifo nut (Calophyllum
inophyllum); usually a small quantity of the second is applied,
and then the part rubbed vigorously with cocoanut oil. Cold water too
for many ailments is much believed in. Recourse in fevers used to be
had almost at once to cold water bandages, a piece of the native cloth
often being left in the water to act as a sort of wick, to keep the
whole damp and cool. The natives have no vessel in which water can
be boiled, except the shell of the cocoanut, and hot water, too, is
never used. It was only by threats that I could get any native to allow
me to use hot water for washing any wound or sore, and hot poultices
were invariably taken off immediately I left the house. Native poultices
are made of the leaves of the taro and hibiscus crushed up; I was also
informed by Marafu that they used to be made of dried arrowroot and
the dried seed of the Tahitian chestnut, and that a certain amount
of turmeric was always mixed with these. The great cure, though, for
all wounds and sores is to roast them for several hours in front of
a slow fire; I found the skin of one man with acute sciatica absolutely
shrivelled up and burnt along the left side from this, massage having
been tried first and failed. The practice of cutting the body where
any pain is felt, which is common in Fiji, I never found any traces
of.

The most prevalent disease in Rotuma is undoubtedly yaws, or framboesia,
known generally under the Fijian name of coko,
though I also heard the Polynesian name, tona,
applied. It is said by the older men to have been an introduced disease
in comparatively recent years. Certainly the older people of both sexes
do not seem to have so many or such large scars from it as the younger
generations, and on some no traces of it are to be seen. The fact,
that the disease is due to inoculation, is well known to the natives,
whom I have known encourage their children, when they have reached
the age of about two years, to play with other children, who have the
disease, in order that they may get it. Commonly the child gets exceedingly
feverish, and then suddenly a number of pustular sores break out, particularly
on the face, hands, and round the waist. The child may be in danger
for some days after this, but usually the fever quickly dies down;
the sores increase in size, and probably cover the whole of the mouth
and nose, reaching a maximum in about a couple of months. They then
gradually commence to dry up, and if the cure does not take place too
rapidly, no further danger need be apprehended, except in combination
with extraneous circumstances such as teething, etc. If the sores,
when they first break out, are healed too quickly as by European antiseptic
treatment, they tend to break out again in a much more virulent form,
and death often supervenes, or else permanent disfigurations of the
face, particularly the nose, or even blindness or lameness. The natives
say that it is a growth, which has to come out, and that, if it is
not allowed to do so properly, it will continue to grow in the bones
and deeper tissues. If the child passes to manhood and then contracts
the disease, it is generally fatal, or else leaves the man so shattered
in health, that he falls a victim to the first epidemic. The child
is carefully guarded for the first year and a half against the disease,
and then the sooner it comes, the better the parents are pleased. No
remedies are applied by the natives, but great care is taken to keep
the child cool and damp, when feverish, and its bowels open; a purgative
draught used to be made from the fruit of the papaw and certain leaves,
but now large quantities of castor oil are sold by the stores. A person,
who has once had this disease, enjoys afterwards complete immunity
from it; I have seen a mother feed from her mouth a child, whose lips
were all swollen with it, without any injurious consequences to herself.

Terrible ulcerations of the skin of the body and limbs, particularly
the leg, are not uncommon among adults, especially women, but they
seem to be easily cured before the age of from forty to fifty years;
they are probably of a granulomatous nature, and are mainly due to
the neglect of sores caused by dirt, poisoning from coral, etc. Such
sores always at first fester, but, if carefully kept clean and open,
heal in a month or two. They are very much neglected by the older people,
particularly the women, are often left uncovered and encouraged to
heal over quickly, only to break out later perhaps all over the limb,
a putrid mass of flesh full of maggots; the mischief has probably now
extended to the bone, the foot doubles up, the limb shrivels, and all
hope of cure may be abandoned. Similar ulcerations also occur among
women, not uncommonly about the age of forty-five, in the breasts;
it is in no way of a cancerous nature, as no disease of that kind is
known. For all these sores, washing daily with a strong solution of
corrosive sublimate has a wonderful effect, especially if accompanied
by doses of potassium iodide. I cannot resist the idea that really
these ulcerations and yaws are of a syphilitic nature and give immunity
from this disease, which is absolutely unknown on the island; other
diseases of a venereal nature too are very rare, owing to the extreme
cleanliness of the women.

There is a consensus of opinion among the natives that coughs, colds,
pleurisy, and pneumonia have been introduced to the island in this
century. This is scarcely likely, but from trustworthy testimony I
think there has been a great intensification of them in recent years,
due to changes in the mode of life. Undoubtedly, though, phthisis has
been introduced in quite recent years; it is a disease of the nature
and duration of which the people are absolutely ignorant. I saw myself
on the island six cases of it, all in a more or less advanced stage;
three were women who had borne children, a fourth was a woman about
twenty-two years of age, and the other two were boys of from seventeen
to nineteen. Both of the latter cases were in Malaha, where the disease
is especially prevalent, owing undoubtedly to the cold damp land breezes
at night, its villages being protected to a large extent from the trade
winds; I found also in Malaha two undoubted cases of goitre, a disease
which I do not remember to have seen in any other district.

Tokalau ringworm (Tinca desquamosa?) was very prevalent formerly
in the island, but, owing to European methods of treatment, has now
become uncommon. In early stages it is readily destroyed by iodine,
but chrysophanic acid is quicker, better, and more effectual in the
later stages. Besides this, the skin often shows more or less ramifying
patches of a lighter tint, but without any desquamation. In some cases
these yield to the same treatment, and are, I think, due to a different Tinea or
some other parasite; in other cases they are perhaps the after-effects
of the regular Tokalau ringworm. The only native method of treatment
is massage with oil, especially after bathing in the salt water.

Fevers of a malarial nature are not uncommon on the island, but they
are much confused with the fevers which always accompany elephantiasis;
they are especially prevalent on the leeward side. They are certainly
distinct from the fevers of elephantiasis, though this disease usually
quickly supervenes and is considered as the result of them. I saw two
cases of such fevers, the patient in one case having had them for about
two years, and in the other case for longer than he could remember,
but in neither case were there any visible signs of elephantiasis.
I saw two cases, too, among children of what seemed to me to be mild
typhoid fevers; the two houses were within a stone's throw of one another.

Elephantiasis is certainly the worst disease that the adult Rotuman
has to contend with; it affects the Europeans in the island equally
as much as the natives. It attacks the men in particular, at least
70 per cent over the age of forty years having it in a more or less
virulent form; of women over the same age I should think not more than
20 per cent are affected. Among the men it takes the form in particular
of elephantiasis scroti. Of twenty-eight men, fifteen had it in the
scrotum alone, nine in the scrotum and legs, three in the scrotum,
legs, and arms, and one in the arms only. I never saw any cases among
men where the legs were affected without the scrotum also being enlarged.
The scrotum does not, as a rule, grow to a very large size until the
man gets old, probably owing to the fact that it is usually kept bound
up by cloths. When it becomes too large, recourse is had to lancing
with a shark's-tooth lancet. In the old days, too, the same instrument
was, according to Marafu, used to remove the scrotum, the operation
being performed in front of a huge fire and taking about two days.
The legs and arms, too, used to be cut right down the surface, the
cicatrices being supposed to prevent them from swelling further. Among
the women the disease is not nearly so prevalent, but it seemed to
me that usually both arms and legs were affected. I saw one case of
the form, known as pudendi. From the way it was spoken of, I do not
think it is of exceedingly rare occurrence on the island. The second
attack of the fever usually comes about six months after the first;
then the attacks increase until perhaps they occur for a short period
fortnightly, after which they gradually decrease in frequency. There
is a distinct increase in size of the organs affected after each attack.
Inquiries as to the origin in individual cases gave me such replies
as "A night's fishing on the reef," "Sleeping in the bush," etc.; most
could give no cause or only supernatural ones.

Periodical epidemics of bad eyes pass over the island; the cornea
gets clouded, and sight is considerably impaired. A few drops of sulphate
of zinc twice a day in the eyes usually effect a speedy cure; the native
remedy is the raw juice of a certain tree with large palmate leaves.
Cases of blindness from this disease are now quite common owing to
neglect.

Serious diseases other than the above, except such as are of an epidemic
nature, are almost unknown. Dysentery passed through the island in
1882, but does not seem to have made a permanent lodgment; constant
requests, on the other hand, are made for opening medicine, and doses
of four ounces of castor oil are often necessary to give relief. Among
the women the menstrual period is often accompanied by headaches, nausea,
and amenorrhoea, or stoppage of the menses. In many cases, though,
I believe, these are due to native medicines, possibly preventative,
administered by the old women.

The lancets are made with the pointed or serrated teeth of the shark,
as desired, tied firmly on a slightly flattened piece of wood, about
the size of a pencil, the tooth never being bored. The point of the
tooth is pressed on the gathering it is desired to open, and then hit
sharply by a piece of stick to drive it in. Broader teeth, with serrated
edges, were used similarly mounted for operations in which cutting
was required.

It may be interesting to note that I examined the blood of eight males,
in six of whom I found the Filaria sanguinis hominis; the other
two were boys, aged about sixteen and nineteen.